Transformation zone location and intraepithelial neoplasia of the cervix uteri.

We examined the relationship between the frequency of premalignant lesions of the cervix and location of the transformation zone on the cervix among 8758 women as assessed using cervicography. An endo- and exocervical smear test was performed at the same time. Women with smear test classified CIN I or more were recalled and any abnormal area was biopsied under colposcopy. The transformation zone was located on the exocervix in 94% of women younger than 25 years old; as age increased, the proportion of women with a transformation zone located on the exocervix steadily decreased to reach less than 2% after 64 years old. As compared with women having a transformation zone in the endocervical canal, the age-adjusted likelihood of discovering a histologically proven dysplastic lesion was 1.8 times more frequent among women with a transformation zone located on the exocervix (95% confidence interval 1.1-2.9). This higher frequency seemed not attributable to a lower sensitivity of the smear test when the transformation zone was hidden. The results also showed that deliveries tended significantly to maintain the transformation zone on the exocervix. Parity is a known risk factor for cervix cancer, but the mechanism by which it favours malignant lesions remain unknown. Our results suggest that with increasing numbers of livebirths, the transformation zone is directly exposed for longer periods to external agents involved in dysplastic lesions

AB0651 CASE-REPORT: ORGANIZING PNEUMONIA IN A PREGNANT WOMAN WITH RHEUMATOID ARTHRITIS DURING COVID-19 PANDEMIC

Conclusion:Case-report: Organizing pneumonia in a pregnant woman with rheumatoid arthritis during Covid-19 pandemicCORNILLIE Alexia, GRIVEGNEE Camille, CHU Charleroi Marie-CurieIntroductionRheumatoid arthritis (RA) is a systemic inflammatory disease characterized by destructive polyarthritis and extra-articular organ involvement. Lungs are one of the most commonly affected organ in RA, and the lung involvement in RA results in a various clinical features including interstitial lung disease (ILD) and organizing pneumonia (OP).OP is a histologic term characterized by the presence of buds of granulation tissue in bronchioles and alveoli. OP can be either idiopathic (cryptogenic organizing pneumonia) or secondary to underlying disease such as infection, drugs or connective tissue disease including RA.Lung biopsy is usually recommended for the diagnosis, but the following criteria fulfilled by patients can lead to the diagnosis: (1) specific radiological manifestations (nonsegmental randomized consolidation with/without ground grass opacities in chest CT), (2) no causative infectious agent, (3) no response to antibiotics and (4) good response to corticosteroid therapy.We describe here the case of organized pneumonia discovered in a pregnant woman with known rheumatoid arthritis during COVID-19 pandemic.Case descriptionA 39-year old moroccan woman, gravida 4, para 1, was admitted during COVID-19 pandemic at 30 weeks’ gestation to maternity hospital with a 1-week history of cough, dyspnea and fever. Her medical history included rheumatoid arthritis and gestational diabetes. She was treated with 5mg of prednisolone daily for her RA. Blood sample showed white blood cell count and C reactive protein at a level of 6860/mm3 and 42mg/L respectively. Chest CT performed at her admission revealed diffuse irregular nodular condensations associated with ground glass infiltrates and a right lower lobe parenchymal condensation with airbronchogram in favor of superinfection. Given circumstances, she was tested twice for SARS-Cov-2 48 hours apart by PCR on nasopharyngeal sample and results came back negative. She was treated empirically with ceftriaxone and azithromycin during the first week and described an improvement in her clinical condition but symptoms reappeared 4 days after stopping treatment. During the 2 following months, until the delivery, the patient remained subpyretic with a nonproductive cough and moderate dyspnea. 5 days after the delivery, due to persistant dyspnea and fever, a new chest CT was performed and revealed similar image findings but some of the irregular nodular condensations showed a reversed halo sign and had a migrating character. Considering this typical image findings, the absence of causative infectious agents (excluded by bronchoalveaolar lavage performed after delivery) and the absence of response to antibiotics, we concluded with a diagnosis of OP secondary to RA without performing lung biopsy samples. A treatment with 48mg of methylprednisolone (and 100mg of azathioprine a few weeks later) was initiated. One month later, she showed a spectacular improvement in her clinical condition. A new chest CT highlighted disappearance of the majority of the ground glass areas and of all the condensations previously described. Methylprednisolone was then progressively tapered.ConclusionOP is a common pulmonary complication that can develop in RA. However, despite ou research, we have not found any other clinical case describing this disorder during pregnancy with RA. Since OP is a non-specific inflammatory response to an aggression of the organism, could we consider that the pregnancy is a state of aggression capable of causing such a response?In addition, this clinical case illustrates the diagnostic challenge of this pathology during the Covid-19 pandemic.Disclosure of Interests:None declared.</jats:sec

Adrenoceptors and regulation of intestinal tone in the isolated colon of the mouse.

Adrenaline, noradrenaline, phenylephrine, dopamine, clonidine and apomorphine at low concentrations (from 10(-9) M to 10(-6) M) contracted the longitudinal muscle of the isolated distal colon of the mouse. Phentolamine, tetrodotoxin and indomethacin antagonized these contractile responses. Yohimbine antagonized them at lower concentrations than prazosin. Dopamine and clonidine had the same contractile activity on preparations from mice pretreated with 6-hydroxydopamine (6-OHDA). Isoprenaline (10(-9) to 3 X 10(-7) M) induced relaxations of the colon which were antagonized by propranolol. At higher concentrations, adrenaline and noradrenaline (from 3 X 10(-7) M), dopamine (from 3 X 10(-5) M), phenylephrine (from 3 X 10(-6) M) and apomorphine (from 10(-4) M) relaxed the colon. Clonidine (10(-6) to 3 X 10(-5) M) inhibited the spontaneous activity of the colon but never induced relaxations. At 10(-4) and 10(-3) M clonidine elicited contractions. Prazosin antagonized the inhibitory effect of phenylephrine and clonidine, a mixture of propranolol and prazosin antagonized the relaxations to adrenaline, noradrenaline and dopamine and unmasked contractions that were sensitive to yohimbine and tetrodotoxin. The relaxations induced by apomorphine and the contractions induced by clonidine (greater than 10(-6) M) were resistant to all these antagonists. Electrical field stimulation (1 ms, 2 Hz, 2-20 V) of the mouse colon induced contractile responses which increased with the frequency of the stimulus. After cessation of stimulation at 4 Hz a rebound contraction was generally observed, followed by a progressive decline in tone. In the presence of atropine, the contractile response to field stimulation was abolished and transformed into a rapid and sustained relaxation. A rebound contraction was always observed after cessation of stimulation. The responses to electrical stimulation (in the presence or absence of atropine) were abolished by tetrodotoxin. The rebound contractions were abolished by indomethacin. The relaxations induced in the presence of atropine were not modified by phentolamine, propranolol, guanethidine, methysergide, mepyramine, cimetidine or naloxone. Tetrodotoxin (from 3 X 10(-8) M) caused a sustained contraction of the colon with increased spontaneous activity. This contraction was not modified by atropine, phentolamine, propranolol, guanethidine, methysergide, mepyramine, cimetidine, naloxone, but was abolished by preincubation of the preparation with indomethacin. These results indicate that, at low concentrations, various sympathomimetics contracted the mouse distal colon by stimulating alpha 2 presynaptic adrenoceptors.(ABSTRACT TRUNCATED AT 400 WORDS

APPORT DU CT DANS LE DIAGNOSTIC ET LE TRAITEMENT DE L'ASPERGILLOME

SCOPUS: ar.jinfo:eu-repo/semantics/publishe